Individual
BENJAMIN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9040 JACKSON AVENUE, TACOMA, WA 98431-0001
(253) 968-3066
(253) 968-0384
Mailing address
9040 JACKSON AVENUE, TACOMA, WA 98431-0001
(253) 968-3066
(253) 968-0384
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
61339518
WA
Other
Enumeration date
04/02/2019
Last updated
03/20/2024
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